Redesigning the Telehealth Experience

Consider lessons learned from COVID-19 to drive adoption forward

By Megan Headley

Telehealth may be here to stay, but it’s not being consistently adopted by all people in all places.

According to the Telehealth Adoption Tracker from The Chartis Group, a healthcare management consulting firm, there have been significant variations in telehealth adoption based on geography, demographic data, and service line, among other factors. The index was designed to measure how rapidly COVID-19 has accelerated the trend of telehealth adoption across the country, and measures data from several million claim records from January 1, 2020, through January 25, 2021. However, it’s also now providing insight into how health systems and physician groups might create a more cohesive telehealth offering going forward.

“We adopted telehealth during the COVID-19 pandemic out of necessity. Now we’re at the point where health systems and physician groups are asking themselves how we can optimize the role that telehealth plays in our care models,” says Chartis Group principal Ryan Bertram.

In flipping the “digital switch” to widespread telehealth during the early days of the pandemic, many organizations were forced to scramble to leverage a variety of solution platforms to meet all patient needs. Now, as vaccinations take hold and infection rates have lessened, many of these same organizations are exploring ways to use lessons learned from COVID-19 in building an enterprisewide telehealth solution. “I think we’ll see an evolution over the next few months and years to really build that enterprise capability out,” Bertram predicts.

The variability in telehealth adoption across the country and across clinical specialties presents some key strategic questions for providers as they evaluate their telehealth portfolios to figure out how they can incorporate telehealth into their broader care models.

Understand the gaps

Chartis’ data indicates that telehealth adoption has been driven more by lack of availability of in-person clinical services than of local COVID-19 outbreaks. However, the most densely populated states are now showing the highest sustained telehealth adoption. Regions such as New England, for example, are demonstrating a greater adoption of telehealth solutions across neighboring state lines. Pockets of sustained adoption are appearing on both coasts and some parts of the Midwest, but telehealth adoption has been lower in most of the Gulf Coast and up through the Great Plains, according to Chartis’ analysis of its findings.

Chartis concludes that health systems in more urban areas may be pushed to transform care models rapidly to compete. However, the firm also notes that the widening gap in sustained telehealth adoption rates between states with the highest adoption (33%) and the lowest adoption (7%) will make it more difficult for low-adopting states to catch up to the digital-forward care models being adopted elsewhere.

“That’s going to be one of the challenges that providers face in more rural communities, where access to broadband may be heterogenous or digital literacy might be lagging,” Bertram says. “It’s not to say that telehealth can’t provide a role in providing care for those patients, but organizations need to design what the telehealth experience is to meet the needs of those patients differently.”

Consider the experience

Crafting an enticing experience across the enterprise will be key in developing a consistent telehealth approach going forward. By Chartis’ analysis, a poor experience may have driven some of the earliest telehealth-adopting consumers back to in-person visits.

At the onset of the pandemic, individuals ages 65 and up were the largest group of telehealth adopters. Today, however, that population accounts for the lowest utilizers of telehealth as tracked by Chartis (14%). Adults ages 18–44 are the highest sustained adopters of telehealth. The trend, Bertram notes, indicates a stronger preference for in-person care, and perhaps an underwhelming telehealth experience, among older patients.

A wide range of factors can contribute to a poor telehealth experience, but providers will need to identify exactly what those factors are to secure customer buy-in where appropriate. “Examples of those barriers might be if I have an experience where I have to download multiple apps in order to get into my visit. Do I have to answer the same questions multiple times? What is the virtual waiting room experience like?” Bertram says.

He suggests that an “outside-in approach to designing the patient experience,” diving deep into the experience of telehealth across the enterprise, will prove critical in long-term adoption.

“A lot of health systems across the country and vendors that are creating these solutions and bringing them to market are now at the point where they need to elevate the experience and recognize those shortcomings,” Bertram adds.

Maintain human-centered design

Although the overall telehealth platform should be consistently integrated across the organization, Bertram emphasizes that there will likely be different ways to approach telehealth in specific service lines. The right approach will be determined by the need for in-person diagnostics and the ability to connect patients with the appropriate members of their care team. In fact, Bertram notes that people, not technology, will play the most critical role in how service lines’ telehealth offerings are developed.

“I would reiterate the importance of human-centered design in all of this,” he says. “Take an outside-in approach to make sure that you understand what patients are experiencing, what the providers and nursing staff are experiencing. That will allow organizations to tweak and improve their models over time for success.”

This may be particularly true in determining which service lines can adequately shift some healthcare experiences to telehealth. Despite relatively similar telehealth adoption levels prior to the pandemic, primary care and medical specialties spiked quickly and maintained their higher adoption compared to surgical specialties. Within specialty areas, sustained adoption was seen in neurology (36%), gastroenterology (29%), and cardiology (23%). These trends indicate which service lines may require more diagnostic insight or where patients especially prize convenience, compared to areas where all parties prefer in-person discussions.

“The last thing we want is a patient to have a telehealth visit where issues can’t be resolved,” Bertram cautions. “You can get ahead of that if you’re more discerning and thoughtful about how you design that care model so that you’re using telehealth for appropriate patient conditions—not thinking that telehealth can replace all in-person care, because it certainly can’t.”

Gather input from all parties

It’s become clear that telehealth solutions will play a key role in patient care going forward, but organizations now must define how their telehealth experience will serve as a differentiator. Health systems and physician groups may want to track their own trends in telehealth usage against national trends to identify opportunities for potential improvement, as well as strengths upon which to capitalize. Now is also the time to secure input on your telehealth experience from everyone involved.

“In the same way we see consumers with variability in their experiences and how that informs their willingness to adopt telehealth, we’re also seeing that on the consumer and care team side,” Bertram notes. “It’s important for healthcare organizations to make sure they take a multidisciplinary approach to planning, building out, and maturing platforms.”

Megan Headley is a freelance writer and owner of ClearStory Publications. She can be reached at